Incremental value of myocardial viability for prediction of Long-Term prognosis in surgically revascularized patients with left ventricular dysfunction

We assessed the incremental long-term prognostic value of myocardial viability in surgically revascularized (CABG) patients with left ventricular (LV) dysfunction. Clinical factors, medical therapy, the degree of LV dysfunction, and stress-induced ischemia may affect the relative prognostic value of...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2003-12, Vol.42 (12), p.2099-2105
Main Authors: Sawada, Stephen, Bapat, Ashutosh, Vaz, Dev, Weksler, Juan, Fineberg, Naomi, Greene, Adam, Gradus-Pizlo, Irmina, Feigenbaum, Harvey
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular disease
Coronary Artery Bypass
Coronary Disease - mortality
Coronary heart disease
Coronary vessels
Dobutamine
Echocardiography
Female
Follow-Up Studies
Heart
Heart - physiology
Heart attacks
Humans
Ischemia
Male
Medical imaging
Medical prognosis
Medical sciences
Middle Aged
Mortality
Multivariate Analysis
Observer Variation
Prognosis
Studies
Survival Rate
Ventricular Dysfunction, Left - complications
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We assessed the incremental long-term prognostic value of myocardial viability in surgically revascularized (CABG) patients with left ventricular (LV) dysfunction. Clinical factors, medical therapy, the degree of LV dysfunction, and stress-induced ischemia may affect the relative prognostic value of myocardial viability. Patients with coronary disease and ventricular dysfunction (mean ejection fraction 33% by echocardiography, 25% by angiography) were studied with dobutamine echocardiography. Follow-up (mean −4.9 years) was obtained in 95 patients (85% triple-vessel disease) who underwent CABG. The use of angiotensin-converting enzyme inhibitors, advanced heart failure, rest, low- and peak-dose wall motion scores were univariate predictors of cardiac death. The extent of contractile reserve and ischemia were not predictive. Low-dose score was the strongest multivariate predictor of death (p < 0.001, hazard ratio 6.7). A biphasic response predicted better survival (p = 0.045, hazard ratio 0.5). Five-year survival was better in those with extensive (low-dose score
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2003.07.026